Evaluating bone health in women with oestrogen receptor positive breast cancer (ERBC) starting aromatase inhibitors.
OBJECTIVE
There is an increase in fractures in women with oestrogen receptor positive breast cancer (ERBC) particularly those taking aromatase inhibitors (AIs). How to identify women at osteoporosis risk, assess bone health and who to treat, are questions not adequately answered by previous studies.


METHODS
We present an audit of osteoporosis risk factors, bone mineral density (BMD) measurement and other data relevant to bone health (falls and laboratory tests) in 85 women with ERBC starting AIs.


RESULTS
Only 9/85 (11%) women overall and only 2/13 with previous peripheral fragility fractures had osteoporosis. Of note, secondary hyperparathyroidism was present in 40% of women <60 years; 67% of women 60-69 years and 75% of women >70 years.


CONCLUSIONS
Reliance on BMD alone to guide decisions for osteoporosis prevention treatment in those taking AIs would lead to few women being treated. Osteoporosis risk in women taking AIs is likely influenced by factors other than those encompassed by BMD alone.
Clunie
G P
GP
Department of Rheumatology and Bone Unit, The Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK. gavin.clunie@ipswichospital.nhs.uk
Clark
A
A
Mortimer
C J
CJ
Stephenson
S
S
Aitken
J
J
Smith
C
C
Sherwin
E
E
Archer
T J
TJ
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000453:epidemiology; D001943:Breast Neoplasms / Q000150:complications*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011960:Receptors, Estrogen; D018570:Risk Assessment; D012307:Risk Factors
D047072:Aromatase Inhibitors; D050071:Bone Density Conservation Agents; D011960:Receptors, Estrogen